E-Cigarettes – Behind the Smoke and Mirrors

Using e-cigarettes, or “vaping”, is among the hottest new trends. Due to a lack of regulation, a variety of flavors (7700), and aggressive marketing, e-cigarette use has skyrocketed in recent years. This is particularly true in the youth demographic, where use tripled from 4.5% in 2013 to 13.4% in 2014. As a result, youth e-cigarette use has surpassed youth cigarette smoking. The $1.7 billion e-cigarette industry is also on track to outsell tobacco products within a decade. Yet, little and conflicting information exists about the safety of this new product. What’s behind the smoke and mirrors?

E-cigarettes are a type of Electronic Nicotine Delivery Systems (like e-pens, e-pipes, e-hookah and e-cigars). They contain a cartridge filled with nicotine, other liquids like propylene glycol, and flavorings. During vaping, a battery-powered heating element heats the cartridge, releasing a chemical filled aerosol. The end of the e-cigarette glows, just like a real cigarette. The user then exhales a cloud of vapor, resembling smoke.

Because no tobacco burning occurs during this process, evidence suggests that e-cigarettes “may be safer than regular cigarettes”. When used as instructed, the levels of dangerous chemicals inhaled are a “fraction” of those from their tobacco counterpart. Thus, according to Dr. Siegel at Boston University, e-cigarettes are preferable to cigarettes. Some also believe that vaping can assist people in quitting smoking, much like nicotine gum.

But don’t light up just yet. Tests reveal that most e-cigarettes contain at least traces of solvents. In addition to irritating lungs, solvents can “transform into something more worrisome: carbonyls”. Carbonyls include known or suspected carcinogens (cancer causing chemicals) such as formaldehyde and acetaldehyde.

Another dangerous chemical in e-cigarettes is nicotine. For adults, nicotine consumption is associated with cardiovascular disease and poisoning. For kids and teens (often drawn to e-cigarettes by the candy flavors and ease of purchase), nicotine can affect brain development. Finally, for fetuses, nicotine can cause lasting consequences for brain and lung function, pre-term delivery, low birth weight, and stillbirth.

Unfortunately, these nicotine concentrations have not caused e-cigarettes to replace tobacco (which also contains the highly addictive chemical). In 2013, 76.8% of those who recently vaped also smoked cigarettes. Some even believe that e-cigarettes could be a “gateway drug” to tobacco by creating nicotine addictions and “making smoking popular again”. Hence, the Center for Drug Evaluation and Research has not approved e-cigarettes as a safe or effective method to quit smoking.

That is what we know – but there is still so much we don’t know about vaping. Because the Food and Drug Administration (FDA) does not yet regulate the 500 brands of e-cigarettes, their exact ingredients are unclear. Initial tests hint that the toxins and nicotine levels in e-cigarettes vary considerably within and between brands. The levels also differ from what packages indicate.

Knowledge of vaping effects is also incomplete. In the words of R. Morgan Griffin, “research into the effects of e-cigarettes lags behind their popularity”. Plus, it will be years before we can discern the effects of long-term use or second-hand exposure.

Through all this haze, a few key take-aways emerge. First and foremost, if you don’t smoke, do not start vaping – there are risks and no health benefits. Secondly, if you smoke cigarettes and wish to quit, don’t rely on e-cigarettes to ease the transition. Rather, opt for an FDA-approved method. Finally, if you plan to continue smoking, talk to your doctor about safer alternatives. Such alternatives may ultimately include e-cigarettes, but further research and regulation is necessary.

To learn more about e-cigarettes and vaping, please contact Action on Smoking and Health, the Foundation for a Smokefree America, or our partners, the American Lung Association and Healthy Lifestyle Choices.



Scientists Feverishly Defend Vaccines after Measles Outbreak

1321321They say Disneyland is the “happiest place on earth”. But over the last month, the theme park has become the epicenter of a major measles outbreak.

According to the Centers for Disease Control and Prevention (CDC), 121 Americans across 17 states contracted measles between January 1 and February 6. At least 103 cases (or 85%) are linked to a California woman who became contagious at Disneyland. She later spread the virus further by traveling to Washington state.

The outbreak has raised concerns across the US. After all, the CDC describes measles—which can cause pneumonia and encephalitis—as “the most deadly of all childhood rash/fever illness”. To make matters worse, the virus is highly contagious. Transmitted via coughing and sneezing, it can survive for up to 2 hours on surfaces and infect 90% of unvaccinated people nearby. As a result, an estimated 20 million people contract measles worldwide every year.

In the US, however, the disease has become relatively rare. For over 40 years, public health officials have administered a 97% effective Mumps, Measles, Rubella (MMR) vaccine, mostly to children and college students. Thus, the average number of measles cases has dropped to 62 per year (from 2001 – 2011).

But here’s a bitter pill to swallow: the trend appears to be reversing. A rumor linking vaccines and autism, spread by people like Jenny McCarthy and discredited doctor Andrew Wakefield, has triggered a growing anti-vaccination movement in the US. This is producing “large pockets of unvaccinated children through whom epidemics can spread further”. In fact, in 2014, 79% of US measles cases involving those unvaccinated due to “personal belief”.

This “anti-vaxx” movement has scientists in a fever pitch. Dr. Natasha Crowcroft, Chief of Infectious Disease with Public Health Ontario, says “There is absolutely no evidence at all” that vaccines cause autism. Dr. Anne Schuchat, Director of the CDC’s National Center for Immunization and Respiratory Diseases, adds “This is not a problem with the measles vaccine…This is a problem of the measles vaccine not being used“. Indeed, “The anti-vaccine movement has turned this public health victory into defeat”.

Still, perhaps some good can come from the latest measles outbreak. In California, for example, parents are waking up to the danger of the anti-vaxx movement and are “pushing back“. This has prompted certain schools to send unvaccinated children home. In other states, like Mississippi and West Virginia, governments have banned parents from refusing vaccinations for their children on philosophical/religious grounds.

To learn more about the measles outbreak, or about the MMR vaccination, please contact our partners, Healthy Lifestyle Choices, the Virginia Association of Free Clinics, and the International Red Cross.


Flickr photo credit: Evan Long